Traumatic Injury

Impacted Teeth

Injuries to the mouth can cause teeth to be pushed back into their sockets. Your endodontist or general dentist may reposition and stabilize your tooth. Root canal treatment is usually started within a few weeks of the injury, and a medication such as calcium hydroxide will be placed inside the tooth. Eventually, a definitive root canal filling will be placed.

Dislodged Teeth (Subluxation)

Sometimes a tooth may be pushed partially out of the socket. Your endodontist or general dentist may reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. If the pulp becomes damaged or infected, root canal treatment will be required.

Knocked-Out Teeth (Avulsion)

If an injury causes a tooth to be completely knocked out of your mouth, it is important that you be treated immediately. If this happens to you, keep the tooth moist. If possible, replant the tooth back in the socket and call your dentist or endodontist. If the tooth cannot be replanted, do not clean it off. Put it in milk to keep it moist until you can be seen by the dentist or endodontist. Based upon the stage of root development, your endodontist may start root canal treatment immediately. The length of time that the tooth was out of the mouth and the medium in which it was stored (e.g. milk, water, dry) may influence the type of treatment you receive.

In Children

An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:

Apexogenesis

This procedure encourages the root to continue to develop as the pulp heals. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the prognosis of the tooth.

Apexification

In this procedure, the unhealthy pulp is removed. The doctors place medication into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures. For this reason, it is important that your dentist properly restore the tooth after this procedure.